Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
9
pubmed:dateCreated
1992-8-20
pubmed:abstractText
High-efficiency (HE) and high-flux (HF) hemodialysis are becoming increasingly popular methods for treating patients with chronic renal failure because they reduce the time required for dialysis treatment. HF and HE dialyzers require bicarbonate dialysate, often prepared from concentrates that can support bacterial growth with endotoxin production. There is a concern that endotoxins or bacteria may cross or interact at the membranes of these dialyzers, triggering the release of endogenous pyrogens (cytokines) by peripheral blood mononuclear cells to cause pyrogenic reactions (PR). To determine the incidence of PR and to examine the association between PR and levels of bacteria and endotoxin in dialysate, a cohort of patients receiving conventional, HE, or HF hemodialysis with bicarbonate dialysate and reprocessed dialyzers at three dialysis centers during a 12-month period was studied prospectively. All dialyzers underwent a test of membrane integrity before use. A total of 19 PR were identified among 18 patients in 26,877 hemodialysis treatments (0.7 PR/1,000 treatments). There was no significant difference in PR rates by treatment modality: conventional, 0.5 per 1,000 (7 PR/13,123 treatments) versus HE, 0.9 per 1,000 (9 PR/11,345) versus HF, 1.2 per 1,000 (3 PR/2,409) (P = 0.21; chi 2 test). Throughout the study period, bacterial counts for dialysate at each center significantly exceeded the Association for the Advancement of Medical Instrumentation's (AAMI) microbiologic standards for dialysate of less than 2,000 CFU/mL (mean, 19,000 CFU/mL), but water used in the reuse of dialyzers tested less than 200 CFU/mL.(ABSTRACT TRUNCATED AT 250 WORDS)
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Mar
pubmed:issn
1046-6673
pubmed:author
pubmed:issnType
Print
pubmed:volume
2
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
1436-44
pubmed:dateRevised
2006-11-15
pubmed:meshHeading
pubmed-meshheading:1627766-Adult, pubmed-meshheading:1627766-Aged, pubmed-meshheading:1627766-Aged, 80 and over, pubmed-meshheading:1627766-Bacteremia, pubmed-meshheading:1627766-Bacteria, pubmed-meshheading:1627766-Bicarbonates, pubmed-meshheading:1627766-Case-Control Studies, pubmed-meshheading:1627766-Cohort Studies, pubmed-meshheading:1627766-Disinfection, pubmed-meshheading:1627766-Drug Contamination, pubmed-meshheading:1627766-Endotoxins, pubmed-meshheading:1627766-Female, pubmed-meshheading:1627766-Fever, pubmed-meshheading:1627766-Georgia, pubmed-meshheading:1627766-Hemodialysis Solutions, pubmed-meshheading:1627766-Humans, pubmed-meshheading:1627766-Incidence, pubmed-meshheading:1627766-Limulus Test, pubmed-meshheading:1627766-Male, pubmed-meshheading:1627766-Middle Aged, pubmed-meshheading:1627766-Population Surveillance, pubmed-meshheading:1627766-Predictive Value of Tests, pubmed-meshheading:1627766-Renal Dialysis, pubmed-meshheading:1627766-Water Supply
pubmed:year
1992
pubmed:articleTitle
Pyrogenic reactions in patients receiving conventional, high-efficiency, or high-flux hemodialysis treatments with bicarbonate dialysate containing high concentrations of bacteria and endotoxin.
pubmed:affiliation
Hospital Infections Program, Centers for Disease Control, Atlanta, GA 30333.
pubmed:publicationType
Journal Article, Research Support, Non-U.S. Gov't